Viruses (Feb 2022)
Factors Associated with Significant Platelet Count Improvement in Thrombocytopenic Chronic Hepatitis C Patients Receiving Direct-Acting Antivirals
- Yen-Chun Chen,
- Te-Sheng Chang,
- Chien-Hung Chen,
- Pin-Nan Cheng,
- Ching-Chu Lo,
- Lein-Ray Mo,
- Chun-Ting Chen,
- Chung-Feng Huang,
- Hsing-Tao Kuo,
- Yi-Hsiang Huang,
- Chi-Ming Tai,
- Cheng-Yuan Peng,
- Ming-Jong Bair,
- Ming-Lun Yeh,
- Chih-Lang Lin,
- Chun-Yen Lin,
- Pei-Lun Lee,
- Lee-Won Chong,
- Chao-Hung Hung,
- Jee-Fu Huang,
- Chi-Chieh Yang,
- Jui-Ting Hu,
- Chih-Wen Lin,
- Chia-Chi Wang,
- Wei-Wen Su,
- Tsai-Yuan Hsieh,
- Chih-Lin Lin,
- Wei-Lun Tsai,
- Tzong-Hsi Lee,
- Guei-Ying Chen,
- Szu-Jen Wang,
- Chun-Chao Chang,
- Sheng-Shun Yang,
- Wen-Chih Wu,
- Chia-Sheng Huang,
- Chou-Kwok Hsiung,
- Chien-Neng Kao,
- Pei-Chien Tsai,
- Chen-Hua Liu,
- Mei-Hsuan Lee,
- Chia-Yen Dai,
- Jia-Horng Kao,
- Wan-Long Chuang,
- Han-Chieh Lin,
- Chi-Yi Chen,
- Kuo-Chih Tseng,
- Ming-Lung Yu,
- on behalf of TACR investigators
Affiliations
- Yen-Chun Chen
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi School of Medicine, Tzuchi University, Hualien 970, Taiwan
- Te-Sheng Chang
- Division of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Chien-Hung Chen
- Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan 333, Taiwan
- Pin-Nan Cheng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Ching-Chu Lo
- Division of Gastroenterology, Department of Internal Medicine, St. Martin De Porres Hospital, Chiayi 600, Taiwan
- Lein-Ray Mo
- Division of Gastroenterology, Tainan Municipal Hospital, Tainan 701, Taiwan
- Chun-Ting Chen
- Division of Gastroenterology, Department of Internal Medicine Tri-Service General Hospital Penghu Branch, National Defense Medical Center, Taipei 114, Taiwan
- Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Hsing-Tao Kuo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Yongkang District, Tainan 710, Taiwan
- Yi-Hsiang Huang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Chi-Ming Tai
- Department of Internal Medicine, E-Da Hospital, Kaohsiung 824, Taiwan
- Cheng-Yuan Peng
- Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung 406, Taiwan
- Ming-Jong Bair
- Division of Gastroenterology, Department of Internal Medicine, Taitung Mackay Memorial Hospital, Taitung 950, Taiwan
- Ming-Lun Yeh
- School of Medicine and Hepatitis Research Center, College of Medicine, Center for Cancer Research, Center for Liquid Biopsy, Cohort Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Chih-Lang Lin
- Department of Gastroenterology and Hepatology, Keelung Chang Gung Memorial Hospital, Keelung 204, Taiwan
- Chun-Yen Lin
- Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Linkou 333, Taiwan
- Pei-Lun Lee
- Chi Mei Medical Center, Liouying Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tainan 736, Taiwan
- Lee-Won Chong
- Division of Hepatology and Gastroenterology, Department of Internal Medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan
- Chao-Hung Hung
- Division of Hepatogastroenterology, Department of Internal Medicine, Chiayi Chang Gung Memorial Hospital and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
- Jee-Fu Huang
- School of Medicine and Hepatitis Research Center, College of Medicine, Center for Cancer Research, Center for Liquid Biopsy, Cohort Research, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Chi-Chieh Yang
- Department of Gastroenterology, Division of Internal Medicine, Show Chwan Memorial Hospital, Changhua 500, Taiwan
- Jui-Ting Hu
- Liver Center, Cathay General Hospital, Taipei 106, Taiwan
- Chih-Wen Lin
- Division of Gastroenterology and Hepatology, E-Da Dachang Hospital, School of Medicine, College of Medicine, I-Shou University, Kaohsiung 824, Taiwan
- Chia-Chi Wang
- Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and School of Medicine, Tzu Chi University, New Taipei City 231, Taiwan
- Wei-Wen Su
- Department of Gastroenterology and Hepatology, Changhua Christian Hospital, Changhua 500, Taiwan
- Tsai-Yuan Hsieh
- Division of Gastroenterology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Chih-Lin Lin
- Department of Gastroenterology, Renai Branch, Taipei City Hospital, Taipei 106, Taiwan
- Wei-Lun Tsai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Tzong-Hsi Lee
- Division of Gastroenterology and Hepatology, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
- Guei-Ying Chen
- Penghu Hospital, Ministry of Health and Welfare, Penghu 880, Taiwan
- Szu-Jen Wang
- Division of Gastroenterology, Department of Internal Medicine, Yuan’s General Hospital, Kaohsiung 802, Taiwan
- Chun-Chao Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan
- Sheng-Shun Yang
- Division of Gastroenterology & Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407, Taiwan
- Wen-Chih Wu
- Wu Wen-Chih Clinic, Kaohsiung 830, Taiwan
- Chia-Sheng Huang
- Yang Ming Hospital, Chiayi 600, Taiwan
- Chou-Kwok Hsiung
- Chou Kwok Hsiung Clinic, Penghu 880, Taiwan
- Chien-Neng Kao
- National Taiwan University Hospital Hsin-Chu Branch, Hsinchu 300, Taiwan
- Pei-Chien Tsai
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Chen-Hua Liu
- Hepatitis Research Center, Department of Internal Medicine, National Taiwan University Hospital, Taipei 106, Taiwan
- Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang-Ming Chiao-Tung University, Taipei 112, Taiwan
- Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Jia-Horng Kao
- Hepatitis Research Center, Department of Internal Medicine, National Taiwan University Hospital, Taipei 106, Taiwan
- Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Han-Chieh Lin
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Chi-Yi Chen
- Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi 600, Taiwan
- Kuo-Chih Tseng
- Department of Internal Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi School of Medicine, Tzuchi University, Hualien 970, Taiwan
- Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- on behalf of TACR investigators
- DOI
- https://doi.org/10.3390/v14020333
- Journal volume & issue
-
Vol. 14,
no. 2
p. 333
Abstract
To clarify the predictive factors of significant platelet count improvement in thrombocytopenic chronic hepatitis C (CHC) patients. CHC patients with baseline platelet counts of 3/μL receiving direct-acting antiviral (DAA) therapy with at least 12-weeks post-treatment follow-up (PTW12) were enrolled. Significant platelet count improvement was defined as a ≥10% increase in platelet counts at PTW12 from baseline. Platelet count evolution at treatment week 4, end-of-treatment, PTW12, and PTW48 was evaluated. This study included 4922 patients. Sustained virologic response after 12 weeks post-treatment was achieved in 98.7% of patients. Platelet counts from baseline, treatment week 4, and end-of-treatment to PTW12 were 108.8 ± 30.2, 121.9 ± 41.1, 123.1 ± 43.0, and 121.1 ± 40.8 × 103/μL, respectively. Overall, 2230 patients (45.3%) showed significant platelet count improvement. Multivariable analysis revealed that age (odds ratio (OR) = 0.99, 95% confidence interval (CI): 0.99–1.00, p = 0.01), diabetes mellitus (DM) (OR = 1.20, 95% CI: 1.06–1.38, p = 0.007), cirrhosis (OR = 0.66, 95% CI: 0.58–0.75, p p p = 0.0003) were independent predictive factors of significant platelet count improvement. Subgroup analyses showed that patients with significant platelet count improvement and sustained virologic responses, regardless of advanced fibrosis, had a significant increase in platelet counts from baseline to treatment week 4, end-of-treatment, PTW12, and PTW48. Young age, presence of DM, absence of cirrhosis, reduced baseline platelet counts, and reduced baseline total bilirubin levels were associated with significant platelet count improvement after DAA therapy in thrombocytopenic CHC patients.
Keywords
- hepatitis C virus
- chronic hepatitis C
- direct-acting antivirals
- platelet count
- thrombocytopenia
- significant platelet count improvement
